Investigators at Kocaeli University, Pediatric Neurology OP Clinic, Turkey, studied the relationship between fine motor skills and seizure and treatment parameters in 44 children with rolandic epilepsy (RE) and compared to 44 healthy controls. The children were aged 8 to 14 years, mean age 10 years, 64% males and 36% females, matched in age, gender and level of education in each group. WISC-R total scores were normal in both groups but the mean score in the RE group was lower than controls (p < 0.006). Fine motor skills as measured by the Purdue Pegboard Test (PPT) were lower in the RE group than in controls. Epileptic focus, treatment, type of treatment, age at onset of seizures, time since last seizure, and total number of seizures did not affect motor skills. RE negatively affected fine motor skills regardless of level of IQ. 
COMMENTARY. Although RE is regarded as a benign disorder, several reports emphasize development of cognitive, behavioral and psychiatric disorders during the active seizure phase, sometimes persisting after the epilepsy remits . Early seizures in RE may interfere with brain development, causing deficits in executive function despite a normal IQ. Cognitive and behavioral abnormalities may outlast the RE .
Month to month fluctuations in cognitive abilities and the frequency and lateralization of interictal EEG spikes are reported, potentially impacting academic performance . Clinical seizure remission was achieved 4-5 years earlier than the recovery of cognitive function. No significant correlations were found between lateralization of EEG changes and the character of the cognitive dysfunction, although age-related lateralization of focal epileptiform activity was present . One study suggests that valproate, ethosuximide or levetiracetam is effective in treatment of transitory cognitive disorders  whereas one other found that medication and duration of epilepsy had no significant effect on language reorganization and performance . RE is associated with negative effects on fine motor skills as well as negative effects on other cognitive functions, although these may be transitory.